Cancer Fatigue

1. What is cancer fatigue?

   Cancer fatigue has long been a catch all term for everything from mild tiredness to complete exhaustion. Cancer patients often describe the experience as a total lack of energy or feeling “bone tired.” This type of fatigue is not only physical; it also can affect social, psychological, and spiritual functioning.

2. What causes cancer fatigue?

   There are many causes of cancer fatigue. The disease itself is often responsible, and any of the three standard treatments for cancer—surgery, chemotherapy, or radiation—may cause fatigue. Emotional fatigue also can occur, because the stress of living with a cancer diagnosis can lead to feelings of despair, depression, helplessness, and futility. Cancer pain and physical discomfort can cause fatigue. Your age, general fitness, and lifestyle also affect how you experience cancer fatigue.

3. What are the effects of cancer fatigue?

   The effects of cancer fatigue vary from person to person. Some people become totally exhausted, while others experience short bouts of fatigue or only feel fatigued every now and then. For some patients, fatigue is only a mild bother, but for others, it is hard to get out of bed or walk up a flight of stairs. Fatigue may also cause shortness of breath, depress appetite, and affect thought processes; it may affect a person’s ability to work or make it necessary to shorten work hours.

   Being aware of some of the possible side effects of cancer fatigue can help the patient and loved ones cope. Family roles may change depending on a person’s ability to parent, handle chores, drive, or be intimate with a partner. Cancer fatigue can affect a person’s ability to concentrate, think clearly, retain information, and make decisions. These problems in turn can lead to depression and anxiety, which can increase physical and emotional fatigue in a seemingly never-ending cycle. Talking with health care providers and loved ones can lessen feelings of frustration, reduced self-esteem, and aloneness due to cancer fatigue.  Communicating about your fatigue also can decrease the likelihood that fatigue will interfere with treatment or the outcome of care.

4. How long can cancer fatigue last?

   People experience fatigue in different ways and for different lengths of time. Fatigue can last for days, weeks, or months. Some people seem to experience “post-cancer fatigue.” This term describes the lack of energy or complete exhaustion that can persist to varying degrees for years.

5. Do low blood counts affect fatigue?

   Generally the answer is yes, but this is a discussion to have with your doctor. Low blood counts can reduce your ability to continue treatment or have it be very effective. Working together with your health care team, you may find that you can benefit from products designed to treat and increase low blood counts.

6. How likely is it that I will get cancer fatigue?

   A national survey released in 1997 found cancer fatigue to be “the most common side effect of cancer and its treatment.” Earlier studies and surveys report that “78–96% of patients receiving chemotherapy experience fatigue.” Patients receiving radiation therapy often experience fatigue that worsens as treatment continues, regardless of treatment site.

7. If it is so common, should I even mention it to my doctor?

   Yes! The effects of cancer fatigue on quality of life are now being recognized and researched. It is important to discuss your fatigue with your health care team so that your fatigue and its effects can be minimized when possible.

8. Fatigue is so personal. How do I describe it to my doctor?

   Fatigue is difficult to measure, but because it can affect your life from hour to hour, day to day, and week to week, it is important to recognize it and accurately describe it. Pay attention to your fatigue and write notes about when you feel more or less fatigued.  Convey this information to your doctor and nurse; try using a scale from one to ten to describe your level of fatigue to your doctor. Note when your energy levels are highest and lowest, and prioritize activities. In this way you can work together to find the treatment plan that will work best for you.

9. What can I or my doctor do to improve this condition?

   There are several things that you can do on your own and with your doctor. For example:

   • Ask your health care team about vitamin and mineral supplements, prescription drugs, and exercise and nutrition that may help.
   • Try varying your eating and sleeping patterns.
   • Ask to be referred to a mental health specialist, physical therapist, and/or nutritionist who works with cancer patients.
   • Join a support group; you may learn ways to manage your fatigue from other group members.
   • Try to find interests or activities that are nourishing, such as meditation or relaxation techniques
   • Educate yourself about the subject of cancer fatigue and the research being done so that you will feel more in control.

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